Efeito da mitomicina C tópica na cicatrização de prega vocal em modelo suíno

Várias terapias adjuvantes à cirurgia vêm sendo usadas para modular o processo cicatricial nas pregas vocais, entre elas a Mitomicina tópica (MTC). OBJETIVOS: Avaliar os efeitos da MTC no processo de cicatrização de pregas vocais de suínos 30 dias após exérese de fragmento de mucosa com laser de CO2 mediante a mensuração da deposição de colágeno. FORMA DE ESTUDO: Experimental em suínos. MATERIAIS E MÉTODOS: Dois grupos de 6 suínos cada foram avaliados após exérese de fragmento de mucosa de prega vocal a laser de CO2 (grupo controle sem uso e grupo experimento com uso de MTC tópica). Após 30 dias os animais foram submetidos à eutanásia, sendo coletadas amostras das pregas vocais para análise histológica, a fim de quantificar a deposição de colágeno mediante coloração de Picrosirius Red. RESULTADOS: A média da área do colágeno total das pregas vocais do grupo controle foi de 2648,03 µm2, enquanto a média do colágeno total das pregas vocais do grupo experimento foi de 2200,30 µm2 (p = 0,0043). CONCLUSÃO: A MTC usada topicamente após a exérese de fragmento de mucosa da prega vocal a laser de CO2 em suínos, diminui, significativamente, a deposição do colágeno total.

Comparison of different methods for the determination of total organic carbon and humic substances in Brazilian soils

ABSTRACTAiming to compare three different methods for the determination of organic carbon (OC) in the soil and fractions of humic substances, seventeen Brazilian soil samples of different classes and textures were evaluated. Amounts of OC in the soil samples and the humic fractions were measured by the dichromate-oxidation method, with and without external heating in a digestion block at 130 °C for 30 min; by the loss-on-ignition method at 450 °C during 5 h and at 600 °C during 6 h; and by the dry combustion method. Dry combustion was used as reference in order to measure the efficiency of the other methods. Soil OC measured by the dichromate-oxidation method with external heating had the highest efficiency and the best results comparing to the reference method. When external heating was not used, the mean recovery efficiency dropped to 71%. The amount of OC was overestimated by the loss-on-ignition methods. Regression equations obtained between total OC contents of the reference method and those of the other methods showed relatively good adjustment, but all intercepts were different from zero (p < 0.01), which suggests that more accuracy can be obtained using not one single correction factor, but considering also the intercept. The Walkley-Black method underestimated the OC contents of the humic fractions, which was associated with the partial oxidation of the humin fraction. Better results were obtained when external heating was used. For the organic matter fractions, the OC in the humic and fulvic acid fractions can be determined without external heating if the reference method is not available, but the humin fraction requires the external heating.

Determination of total petroleum hydrocarbons in soil from different locations using infrared spectrophotometry and gas chromatography

Total petroleum hydrocarbons (TPH) are important environmental contaminants which are toxic to human and environmental receptors. Several analytical methods have been used to quantify TPH levels in contaminated soils, specifically through infrared spectrometry (IR) and gas chromatography (GC). Despite being two of the most used techniques, some issues remain that have been inadequately studied: a) applicability of both techniques to soils contaminated with two distinct types of fuel (petrol and diesel), b) influence of the soil natural organic matter content on the results achieved by various analytical methods, and c) evaluation of the performance of both techniques in analyses of soils with different levels of contamination (presumably non-contaminated and potentially contaminated). The main objectives of this work were to answer these questions and to provide more complete information about the potentials and limitations of GC and IR techniques. The results led us to the following conclusions: a) IR analysis of soils contaminated with petrol is not suitable due to volatilisation losses, b) there is a significant influence of organic matter in IR analysis, and c) both techniques demonstrated the capacity to accurately quantify TPH in soils, irrespective of their contamination levels.

Risk factors for metabolic bone disease in Crohn's disease patients

Background: The aim was to evaluate the presence of metabolic bone disease (MBD) in patients with Crohn’s disease (CD) and to identify potential etiologic factors. Methods: The case–control study included 99 patients with CD and 56 controls with a similar age and gender distribution. Both groups had dual-energy x-ray absorptionmetry and a nutritional evaluation. Single nucleotide polymorphisms at the IL1, TNF-a, LTa, and IL-6 genes were analyzed in patients only. Statistical analysis was performed using SPSS software. Results: The prevalence of MBD was significantly higher in patients (P ¼ 0.006). CD patients with osteoporosis were older (P < 0.005), small bowel involvement and surgical resections were more frequent (P < 0.005), they more often exhibited a penetrating or stricturing phenotype (P < 0.05), duration of disease over 15 years (P < 0.005), and body mass index (BMI) under 18.5 kg/m2 (P < 0.01) were more often found. No association was found with steroid use. Patients with a Z-score < 2.0 more frequently had chronic active disease (P < 0.05). With regard to diet, low vitamin K intake was more frequent (P ¼ 0.03) and intake of total, monounsaturated, and polyunsaturated fat was higher in patients with Z-score < 2.0 (P < 0.05). With respect to genetics, carriage of the polymorphic allele for LTa252 A/G was associated with a higher risk of osteoporosis (P ¼ 0.02). Regression analysis showed that age over 40 years, chronic active disease, and previous colonic resections were independently associated with the risk of developing MBD. Conclusions: The prevalence of MBD was significantly higher in CD patients. Besides the usual risk factors, we observed that factors related to chronic active and long-lasting disease increased the risk of MBD.

A comprehensive approach to evaluate nutritional status in Crohn's patients in the era of biologic therapy: a case-control study

Objectives - Evaluate the nutritional status of patients with inactive or mildly active Crohn's disease (CD), and identify possible causes for potential deficiencies. Methods - A total of 78 CD patients and 80 healthy controls were evaluated in respect of nutritional status, dietary intake, and life styles factors. Results - These 73/78 CD patients were on immunomodulating therapies. Mean body mass index (BMI) was lower in patients as compared to controls (P= 0.006) but 32% of CD patients and 33.8% of controls had a BMI > 25, whereas 8% and 23.8% in each group, respectively, were obese (BMI > 30Kg/m(2)). Fat free mass was significantly decreased in both genders (P < 0.05) whereas fat mass was decreased only in males (P= 0.01). Energy intake was significantly lower in CD patients (P < 0.0001) and we observed significantly lower adjusted mean daily intakes of carbohydrates, monounsaturated fat, fiber, calcium, and vitamins C, D, E, and K (P < 0.05). 29% of patients had excluded grains from their usual diet, 28% milk, 18% vegetables, and 11% fruits. Milk exclusion resulted in a significantly lower consumption of calcium and vitamin K (P < 0.001) and the exclusion of vegetables was associated to a lower consumption of vitamins C and E (P < 0.05). Physical activity was significantly lower in CD patients (P= 0.01) and this lack of physical activity was inversely correlated with increased fat mass percentage (r=-0.315, P= 0.001). Conclusions - Results showed that the most prevalent form of malnutrition in CD patients was an excess of body weight, which was concomitant with an inadequate dietary intake, namely micronutrients, clearly related to dietary exclusion of certain foods.

5' and 3' UTR thymidylate synthase polymorphisms modulate the risk of colorectal cancer independently of the intake of methyl group donors

Thymidylate synthase, as a rate-limiting step in DNA synthesis, catalyses the conversion of dUMP into dTMP using 5,10-methylenotetrahydrofolate as the methyl donor. Two polymorphisms have been described in this gene: a repeat polymorphism in the 5' promoter enhancer region (3R versus 2R) and a 6 bp deletion in the 3' unstranslated region. Both of these may affect protein levels. The present case control study was aimed at investigating the influence of these two polymorphisms on the development of colorectal cancer (CRC), as well as their potential interaction with folate, vitamin B6 and vitamin B12 intake. A total of 196 cases and 200 controls, matched for age and sex distribution, were included in the study. No association was found between CRC and the 28 bp repeat polymorphism, but it was observed that individuals with the 6 bp/del and del/del genotypes had a significantly lower risk of developing the disease (OR=0.47; 95% CI 0.30-0.72). A combined genotype (2R/2R; 6 bp/del+del/del) was also found, which was associated with an even lower risk of developing of the disease (OR=0.42; 95% CI 0.26-0.69). No significant interaction between these polymorphisms and vitamin intake was observed. These results indicate for the first time that the 6 bp/del allele might be a protective factor in the development of CRC, independent of the intake of methyl group donors.

A gestão dos custos da qualidade: Modelo A.B.Q.C. aplicado à Mercauto

Mestrado em Controlo e Gestão dos Negócios

Infecção pelo vírus da hepatite C em gestantes em Mato Grosso do Sul, 2005-2007

O estudo teve por objetivo estimar a prevalência da infecção e genótipo do vírus da hepatite C (HCV), bem como determinar a subnotificação de casos. O total de 115.386 gestantes atendidas pelo Programa Estadual de Proteção à Gestante de Mato Grosso do Sul foi submetido à coleta de sangue para a detecção de anti-HCV, de 2005 a 2007. A prevalência da infecção pelo HCV foi de 1,07 casos/1.000. As amostras positivas foram submetidas à detecção do HCV-RNA e genotipadas. O genótipo 1 foi encontrado em 73% das amostras, 24,3% pertenciam ao genótipo 3 e 2,7% ao genótipo 2. A subnotificação de casos de hepatite C foi de 35,5%.

Complemento hemolítico total, C3 e taxa de conversão de C3 nas formas cardíaca e indeterminada da doença de Chagas

Os valores de complemento hemolítico total, C3 total (nativo + produtos de degradação) e o grau de conversão de C3 nativo foram estudados em dois subgrupos de pacientes chagásicos, nas formas cardíaca e indeterminada, e em um subgrupo de indivíduos não chagásicos, clinicamente sadios. Os níveis de C3 total e as taxas de conversão de C3 em seus produtos de degradação foram semelhantes nos três subgrupos. Os valores de complemento hemolítico total foram estatisticamente diferentes nos três subgrupos (nível de significância descritivo p = 0,0757), tendo sido observada média aritmética mais baixa no subgrupo de cardíacos e mais elevada no subgrupo de controles. Maior amplitude de variação dos níveis de complemento hemolítico total foi notada no subgrupo de cardíacos, no qual se encontraram os valores extremos (máximo e mínimo), considerando-se todos os subgrupos.

Pose Estimation using a C-Arm Fluoroscope

Os métodos clínicos que são realizados com recurso a tecnologias de imagiologia têm registado um aumento de popularidade nas últimas duas décadas. Os procedimentos tradicionais usados em cirurgia têm sido substituídos por métodos minimamente invasivos de forma a conseguir diminuir os custos associados e aperfeiçoar factores relacionados com a produtividade. Procedimentos clínicos modernos como a broncoscopia e a cardiologia são caracterizados por se focarem na minimização de acções invasivas, com os arcos em ‘C’ a adoptarem um papel relevante nesta área. Apesar de o arco em ‘C’ ser uma tecnologia amplamente utilizada no auxílio da navegação em intervenções minimamente invasivas, este falha na qualidade da informação fornecida ao cirurgião. A informação obtida em duas dimensões não é suficiente para proporcionar uma compreensão total da localização tridimensional da região de interesse, revelando-se como uma tarefa essencial o estabelecimento de um método que permita a aquisição de informação tridimensional. O primeiro passo para alcançar este objectivo foi dado ao definir um método que permite a estimativa da posição e orientação de um objecto em relação ao arco em ‘C’. De forma a realizar os testes com o arco em ‘C’, a geometria deste teve que ser inicialmente definida e a calibração do sistema feita. O trabalho desenvolvido e apresentado nesta tese foca-se num método que provou ser suficientemente sustentável e eficiente para se estabelecer como um ponto de partida no caminho para alcançar o objectivo principal: o desenvolvimento de uma técnica que permita o aperfeiçoamento da qualidade da informação adquirida com o arco em ‘C’ durante uma intervenção clínica.

Nutritional composition of low protein and phenylalanine-restricted dishes prepared for phenylketonuric patients

Nutritional management is essential for Phenylketonuria (PKU) treatment, consisting in a semi-synthetic and low phenylalanine (Phe) diet, which includes strictly controlled amounts of low protein natural foods (essentially fruits and vegetables) supplemented with Phe-free protein substitutes and dietetic low-protein products. PKU diet has to be carefully planned, providing the best ingredient combinations, so that patients can achieve good metabolic control and an adequate nutritional status. Hereupon, it is mandatory to know the detailed composition of natural and/or cooked foodstuffs prepared specifically for these patients. We intended to evaluate sixteen dishes specifically prepared for PKU patients, regarding the nutritional composition, Phe and tyrosine (Tyr) contents, fatty acids profile, and vitamins E and B12 amounts. The nutritional composition of the cooked samples was 15.5–92.0 g/100 g, for moisture; 0.7–3.2 g/100 g, for protein; 0.1–25.0 g/100 g, for total fat; and 5.0–62.0 g/100 g, for total carbohydrates. Fatty acids profile and vitamin E amount reflected the type of fat used. All samples were poor in vitamin B12 (0.3–0.8 μg/100 g). Boiled rice presented the highest Phe content: 50.3 mg/g of protein. These data allow a more accurate calculation of the diet portions to be ingested by the patients according to their individual tolerance.

Octopus Lipid and Vitamin E Composition: Interspecies, Interorigin, and Nutritional Variability

Octopus vulgaris, Octopus maya, and Eledone cirrhosa from distinct marine environments [Northeast Atlantic (NEA), Northwest Atlantic (NWA), Eastern Central Atlantic, Western Central Atlantic (WCA), Pacific Ocean, and Mediterranean Sea] were characterized regarding their lipid and vitamin E composition. These species are those commercially more relevant worldwide. Significant interspecies and interorigin differences were observed. Unsaturated fatty acids account for more than 65% of total fatty acids, mostly ω-3 PUFA due to docosahexaenoic (18.4−29.3%) and eicosapentanoic acid (11.4− 23.9%) contributions. The highest ω-3 PUFA amounts and ω-3/ω-6 ratios were quantified in the heaviest specimens, O. vulgaris from NWA, with high market price, and simultaneously in the lowest graded samples, E. cirrhosa from NEA, of reduced dimensions. Although having the highest cholesterol contents, E. cirrhosa from NEA and O. maya from WCA have also higher protective fatty acid indexes. Chemometric discrimination allowed clustering the selected species and several origins based on lipid and vitamin E profiles.

Fresh-cut aromatic herbs: Nutritional quality stability during shelf-life

Fresh-cut vegetables are a successful convenient healthy food. Nowadays, the presence of new varieties of minimally processed vegetables in the market is common in response to the consumers demand for new flavours and high quality products. Within the most recent fresh-cut products are the aromatic herbs. In this work, the objective was to evaluate the nutritional quality and stability of four fresh-cut aromatic herbs. Several physicochemical quality characteristics (colour, pH, total soluble solids, and total titratable acidity) were monitored in fresh-cut chives, coriander, spearmint and parsley leaves, stored under refrigeration (3 ± 1 ºC) during 10 days. Their nutritional composition was determined, including mineral composition (phosphorous, potassium, sodium, calcium, magnesium, iron, zinc, manganese and copper) and fat- and water-soluble vitamin contents. Total soluble phenolics, flavonoids and the antioxidant capacity were determined by spectrophotometric methods. The aromatic herbs kept their fresh appearance during the storage, maintaining their colour throughout shelf-life. Their macronutrient composition and mineral content were stable during storage. Coriander had the highest mineral and fatsoluble vitamin content, while spearmint showed the best scores in the phenolic, flavonoid and antioxidant capacity assays. Vitamins and antioxidant capacity showed some variation during storage, with a differential behaviour of each compound according to the sample.

Total IgE detection in paired cerebrospinal fluid and serum samples from patients with neurocysticercosis

Neurocysticercosis (NC), the presence of Taenia solium metacestodes in tissues, is the most frequent and severe parasitic infection of the central nervous system. We investigated the presence of total IgE by an automated chemiluminescence assay in 53 paired cerebrospinal fluid (CSF) and serum samples from patients with NC (P) and in 40 CSF samples from individuals with other neurological disorders as the control group (C). Total IgE concentration ranged from 1.2 to 6.6 IU/ml (mean = 1.4 IU/ml, standard deviation-sd = 1.1 IU/ml) in 28.3% of CSF samples from the P group, a value significantly higher than for the C group (£1.0 IU/ml). The serum samples from the P group showed concentrations ranging from 1.0 to 2330.0 IU/ml (mean = 224.1 IU/ml, sd = 452.1 IU/ml), which were higher than the normal value cited by the manufacturer (<100.0 IU/ml) in 32.1% of the samples. A significant difference was observed in CSF samples from the P and C groups (p = 0.005) and in serum samples from the P group compared to the normal value (p = 0.005), with sera showing more frequent abnormal results.

Prevalence of hepatitis B and C in the sera of patients with HIV infection in São Paulo, Brazil

The objective of this study was to evaluate the prevalence of hepatitis B and C viruses in a group of HIV infected patients, followed at a single institution since 1996. 1,693 HIV positive patients (1,162 male, 531 female) were tested for HBV infection. Virological markers for HBV included HBsAg and total anti-HBc by ELISA. 1,457 patients (1,009 male, 448 female) were tested for HCV infection. Detection of HCV antibodies was carried out by ELISA. A sample of HCV antibody positive patients was tested for HCV by PCR to confirm infection. Of 1,693 patients tested for HBV, 654 (38.6%) and 96 (5.7%) were anti-HBc and HBsAg positive, respectively. Of 1,457 patients tested for HCV, 258 (17.7%) were anti-HCV positive. 82 of these patients were also tested by PCR and 81 were positive (98%). Of 1,411 patients tested for HBV and HCV 26 (1.8%) were positive for both viruses.